Crohn's disease can sometimes be hard to diagnose because its symptoms are like the symptoms of other GI diseases. Plus, there is no single test that can establish the diagnosis of Crohn's disease with certainty. Because Crohn's disease often mimics other conditions and symptoms may vary widely, it may take some time to arrive at the correct diagnosis.
To determine a diagnosis, physicians evaluate a combination of information exams and tests and first exclude other known causes of intestinal inflammation. You can first schedule an appointment to see your family doctor. Then, your doctor may refer you to an internist or a specialist in diseases of the digestive system, called a gastroenterologist.
A detailed personal history, a physical exam, and other tests are needed to diagnose Crohn's disease. During your visit, the doctor will ask about your symptoms and health. The doctor may also run blood tests and you may be asked for a stool sample. By testing a stool sample, the doctor can tell if there is bleeding or infection in the intestines. Stool cultures are also routines used to make sure that an infection is not causing the symptoms. A series of tests may be required to diagnose Crohn's disease. These include:
Biopsy - It may be necessary to perform a biopsy during diagnosis for Crohn's Disease, which involves taking a sample of tissue from the lining of the intestine to view with a microscope.
Blood tests - During diagnosis, your doctor may also request blood tests to check for anemia, which can indicate bleeding in the intestines. Blood tests also uncover high WBC (white blood-cell count), ESR (erythrocyte sedimentation rate), or CRP (C-reactive protein), which all are a sign of inflammation somewhere in the body.
Computerized tomography CT scan - A CT scan is a special X-ray technique that provides more details than a standard X-ray. This test takes images of the entire bowel as well as of tissues outside the bowel that can't be seen with other tests. Doctors use CT scans to understand the location and extent of disease or to check for complications such as a partial blockages, abscesses or fistulas.
Upper GI series - Your doctor may also perform an upper GI series to examine the small intestine. During this test, you drink barium, a chalky solution that coats the lining of the small intestine, and then the doctor will take X-rays of the GI (gastrointestinal) tract. Barium shows up white on X-ray film, revealing inflammation or other abnormalities in the intestine.
Visual exams of the colon - Your doctor might order either a sigmoidoscopy or a colonoscopy. During these tests, a long, flexible, lighted tube, linked to a computer and TV monitor, is inserted into the anus. A sigmoidoscopy allows the doctor to examine the lining of the lower part of the large intestine, while a colonoscopy allows the doctor to examine the lining of the entire large intestine. The doctor will be able to see any inflammation or bleeding during either of these exams, although a colonoscopy is usually a better test because the doctor can see the entire large intestine.
X-rays - If diagnostic tests indicate the possibility of Crohn's disease, more X-rays of both the upper and lower digestive tract may be necessary to see how much of the GI tract is affected by the disease.
Various treatment options exist for people with Crohn's, which can help reduce and manage symptoms. To learn more about various therapies, read the section that follows about how to treat Crohn's Disease. We cover medications, surgery, lifestyle changes and what foods to avoid if I have crohn s in the next section on Treating Crohn's Disease.